Externalized conductors and insulation failure in Biotronik defibrillator leads: History repeating or a false alarm?

Conductor externalization and insulation failure are frequent complications with the recalled St. Jude Medical Riata implantable cardioverter-defibrillator(ICD) leads. Conductor externalization is a "unique" failure mechanism: Cables externalize through the insulation("inside-out" abrasion) and appear outside the lead body. Recently, single reports described a similar failure also for Biotronik leads. Moreover, some studies reported a high rate of electrical dysfunction(not only insulation failure) with Biotronik Linox leads and a reduced survival rate in comparison with the competitors. In this paper we describe the case of a patient with a Biotronik Kentrox ICD lead presenting with signs of insulation failure and conductor externalization at fluoroscopy. Due to the high risk of extraction we decided to implant a new lead, abandoning the damaged one; lead reimplant was uneventful. Subsequently, we review currently available literature about Biotronik Kentrox and Linox ICD lead failure and in particular externalized conductors. Some single-center studies and a nonprospective registry reported a survival rate between 88% and 91% at 5 years for Linox leads, significantly worse than that of other manufacturers. However, the preliminary results of two ongoing multicenter, prospective registries(GALAXY and CELESTIAL) showed 96% survival rate at 5 years after implant, well within industry standards. Ongoing data collection is needed to confirm longer-term performance of this family of ICD leads.

Mechanical Performance of Bio-inspired Bidirectional Corrugated Sandwich Pressure Shell Under External Hydrostatic Pressure

This paper aims to enhance the compression capacity of underwater cylindrical shells by adopting the corrugated sandwich structure of cuttlebone.The cuttlebone suffers uniaxial external compression,while underwater cylindrical shells are in a biaxial compressive stress state.To suit the biaxial compressive stress state,a novel bidirectional corrugated sandwich structure is proposed to improve the bearing capacity of cylindrical shells.The static and buckling analysis for the sandwich shell and the unstiffened cylindrical shell with the same volume-weight ratio are studied by numerical simulation.It is indicated that the proposed sandwich shell can effectively reduce the ratio between circumferential and axial stress from 2 to 1.25 and improve the critical buckling load by about 1.63 times.Numerical simulation shows that optimizing and adjusting the structural parameters could significantly improve the advantage of the sandwich shell.Then,the hydrostatic pressure tests for shell models fabricated by 3D printing are carried out.According to the experimental results,the overall failure position of the sandwich shell is at the center part of the sandwich shell.It has been found the average critical load of the proposed sandwich shell models exceeds two times that of the unstiffened shell models.Hence,the proposed bio-inspired bidirectional corrugated sandwich structure can significantly enhance the pressure resistance capability of cylindrical shells.

Effects of vacancy and external electric field on the electronic properties of the MoSi_(2)N_(4)/graphene heterostructure

Recently,the newly synthesized septuple-atomic layer two-dimensional(2D)material MoSi_(2)N_(4)(MSN)has attracted attention worldwide.Our work delves into the effect of vacancies and external electric fields on the electronic properties of the MSN/graphene(Gr)heterostructure using first-principles calculation.We find that four types of defective structures,N-in,N-out,Si and Mo vacancy defects of monolayer MSN and MSN/Gr heterostructure are stable in air.Moreover,vacancy defects can effectively modulate the charge transfer at the interface of the MSN/Gr heterostructure as well as the work function of the pristine monolayer MSN and MSN/Gr heterostructure.Finally,the application of an external electric field enables the dynamic switching between n-type and p-type Schottky contacts.Our work may offer the possibility of exceeding the capabilities of conventional Schottky diodes based on MSN/Gr heterostructures.

An Investigation of Moxibustion Treatment for Abscesses in the Song Dynasty:Focusing on the“Jiu Ai Tu”

Jiu Ai Tu(The Moxa Treatment)from the Song dynasty is the earliest surviving painting that focuses on the subject of acupuncture and moxibustion.This paper takes the medical activities depicted in the artwork as its research object and systematically analyzes the external treatment methods for abscesses during the Song dynasty reflected in Jiu Ai Tu.By examining the understanding of abscesses during that period,the paper explores the level of development in external medicine techniques.By analyzing the medical awareness and behaviors of patients when facing such severe illnesses,it aims to explore the societal cognition and experiences regarding health and disease.The paper attempts to present the folk medical ecology of the Song dynasty represented by Jiu Ai Tu.

Unraveling the efficacy network: A network meta-analysis of adjuvant external beam radiation therapy methods after hepatectomy

BACKGROUND Primary liver cancer is a malignant tumor with a high recurrence rate that significantly affects patient prognosis.Postoperative adjuvant external radiation therapy(RT)has been shown to effectively prevent recurrence after liver cancer resection.However,there are multiple RT techniques available,and the differ-ential effects of these techniques in preventing postoperative liver cancer re-currence require further investigation.AIM To assess the advantages and disadvantages of various adjuvant external RT methods after liver resection based on overall survival(OS)and disease-free survival(DFS)and to determine the optimal strategy.METHODS This study involved network meta-analyses and followed the PRISMA guidelines.The data of qualified studies published before July 10,2023,were collected from PubMed,Embase,the Web of Science,and the Cochrane Library.We included relevant studies on postoperative external beam RT after liver resection that had OS and DFS as the primary endpoints.The magnitudes of the effects were determined using risk ratios with 95%confidential intervals.The results were analyzed using R software and STATA software.RESULTS A total of 12 studies,including 1265 patients with hepatocellular carcinoma(HCC)after liver resection,were included in this study.There was no significant heterogeneity in the direct paired comparisons,and there were no significant differences in the inclusion or exclusion criteria,intervention measures,or outcome indicators,meeting the assumptions of heterogeneity and transitivity.OS analysis revealed that patients who underwent stereotactic body radiotherapy(SBRT)after resection had longer OS than those who underwent intensity modulated radiotherapy(IMRT)or 3-dimensional conformal RT(3D-CRT).DFS analysis revealed that patients who underwent 3D-CRT after resection had the longest DFS.Patients who underwent IMRT after resection had longer OS than those who underwent 3D-CRT and longer DFS than those who underwent SBRT.CONCLUSION HCC patients who undergo liver cancer resection must consider distinct advantages and disadvantages when choosing between SBRT and 3D-CRT.IMRT,a RT technique that is associated with longer OS than 3D-CRT and longer DFS than SBRT,may be a preferred option.

Discovery of the Significant Impacts of Swell Propagation on Global Wave Climate Change

This study compared the differences in the wave climate in the South China Sea and North Indian Ocean under these two datasets:ERA-40 wave reanalysis and Mei’s hindcast wave data.In the numerical calculation of regional ocean waves,the wave climate characteristics exhibited significant bias if the influence of external swells(swells from afar)was not fully considered,which may provide an incorrect basis for global climate change analysis.1)The trends of the significant wave height(SWH)obtained from the two datasets showed significant differences,such as those of the Bay of Bengal and the Java Sea in June-July-August.For the past 45 years,SWH from ERA-40(SWH-ERA)exhibited a significant annual increase in low-latitude waters of the North Indian Ocean(0.2-0.6 cm yr^(-1))and South China Sea(0.2-0.8 cm yr^(-1)).2)In the Bay of Bengal,the SWH-ERA in each month was generally 0.5 m higher than the SWH from Mei’s hindcast wave data(SWH-Mei)and can reach 1.0 m higher in some months.3)In the Bay of Bengal,SWH-ERA and SWH-Mei increased significantly at annual rates of 0.13 and 0.27 cm yr^(-1),respectively.This increasing trend was mainly reflected after 1978.SWH-ERA showed a trough in 1975(1.33 m)and a crest in 1992(1.83 m),which were not reflected in SWH-Mei.

Combining Thermochronology and Geochronology to Constrains Orogenic Processes in the Alps and Tibet

Deciphering the kinematics of deformation is key to understand the crustal evolution.In the last decades several techniques have been developed to help constraining the timing of deformation.On one side geochronology techniques allow the dating of a wider range of minerals with higher spatial resolution.On the other side thermochronology,with the help of numerical simulations(PeCube,QTQt…),help to constrain the rock exhumation history that is often linked to the vertical component of deformation.In both cases the deformation timing can accurately be discussed only together with a serious structural analysis.

Influence of introducing Zr,Ti,Nb and Ce elements on externally solidified crystals and mechanical properties of high-pressure die-casting Al–Si alloy

High pressure die casting(HPDC)AlSi10Mn Mg alloy castings are widely used in the automobile industry.Mg can optimize the mechanical properties of castings through heat treatment,while the release of thermal stress arouses the deformation of large integrated die-castings.Herein,the development of non-heat treatment Al alloys is becoming the hot topic.In addition,HPDC contains externally solidified crystals(ESCs),which are detrimental to the mechanical properties of castings.To achieve high strength and toughness of non-heat treatment die-casting Al-Si alloy,we used AlSi9Mn alloy as matrix with the introduction of Zr,Ti,Nb,and Ce.Their influences on ESCs and mechanical properties were systematically investigated through three-dimensional reconstruction and thermodynamic simulation.Our results reveal that the addition of Ti increased ESCs'size and porosity,while the introduction of Nb refined ESCs and decreased porosity.Meanwhile,large-sized Al_3(Zr,Ti)phases formed and degraded the mechanical properties.Subsequent introduction of Ce resulted in the poisoning effect and reduced mechanical properties.

Effect of external magnetic field on the instability of THz plasma waves in nanoscale graphene field-effect transistors

The instability of plasma waves in the channel of field-effect transistors will cause the electromagnetic waves with THz frequency.Based on a self-consistent quantum hydrodynamic model,the instability of THz plasmas waves in the channel of graphene field-effect transistors has been investigated with external magnetic field and quantum effects.We analyzed the influence of weak magnetic fields,quantum effects,device size,and temperature on the instability of plasma waves under asymmetric boundary conditions numerically.The results show that the magnetic fields,quantum effects,and the thickness of the dielectric layer between the gate and the channel can increase the radiation frequency.Additionally,we observed that increase in temperature leads to a decrease in both oscillation frequency and instability increment.The numerical results and accompanying images obtained from our simulations provide support for the above conclusions.

Biomedical application of materials for external auditory canal: History,challenges, and clinical prospects

Biomaterials play an integral role in treatment of external auditory canal (EAC) diseases. Regarding the specialanatomic structure and physiological characteristics of EAC, careful selection of applicable biomaterials wasessential step towards effective management of EAC conditions. The bioactive materials can provide reasonablebiocompatibility, reduce risk of host pro-inflammatory response and immune rejection, and promote the healingprocess. In therapeutic procedure, biomaterials were employed for covering or packing the wound, protection ofthe damaged tissue, and maintaining of normal structures and functions of the EAC. Therefore, understandingand application of biomaterials was key to obtaining great rehabilitation in therapy of EAC diseases. In clinicalpractice, biomaterials were recognized as an important part in the treatment of different EAC diseases. Thechoice of biomaterials was distinct according to the requirements of various diseases. As a result, awareness ofproperty regarding different biomaterials was fundamental for appropriate selection of therapeutic substances indifferent EAC diseases. In this review, we firstly introduced the characteristics of EAC structures and physiology,and EAC pathologies were summarized secondarily. From the viewpoint of biomaterials, the different materialsapplied to individual diseases were outlined in categories. Besides, the underlying future of therapeutic EACbiomaterials was discussed.

Transient Experiments on a Prototype Pump with an Atypical Open Impeller for Different Discharge Valve Openings

In order to obtain the transient characteristics of a low-speed centrifugal pump during the start-up and shutdown stages,dedicated experimental tests were conducted with eight different valve opening conditions.The Pearson correlation coefficient was used to reveal the linear correlation between variables.According to the results,the stable rotational speed decreases with increasing valve opening(rotational speed decreases from approximately 1472 to 1453 r/min),while the stable shaft power exhibits an increasing trend(shaft power increases from approximately 0.242 to 0.390 kW).The stable time and zeroing time of each parameter during start-up and shutdown processes vary,with the flow zeroing time significantly increasing with the relative flow,reaching up to 10.468 s,while the shaft power zeroing time is roughly between 1.219 and 1.375 s.The results demonstrate that with increasing valve opening,the stable and zeroing time of flow significantly increase(|r|greater than 0.95),while the stable and zeroing time of rotational speed,power,and head display a smaller sensitivity on the valve opening(|r|less than 0.6).

Effect of slow shot speed on externally solidified crystal,porosity and tensile property in a newly developed high-pressure die-cast Al-Si alloy

The effect of slow shot speed on externally solidified crystal(ESC),porosity and tensile property in a newly developed high-pressure die-cast Al-Si alloy was investigated by optical microscopy(OM),scanning electron microscopy(SEM)and laboratory computed tomography(CT).Results showed that the newly developed AlSi9MnMoV alloy exhibited improved mechanical properties when compared to the AlSi10MnMg alloy.The AlSi9MnMoV alloy,which was designed with trace multicomponent additions,displays a notable grain refining effect in comparison to the AlSi10MnMg alloy.Refining elements Ti,Zr,V,Nb,B promote heterogeneous nucleation and reduce the grain size of primaryα-Al.At a lower slow shot speed,the large ESCs are easier to form and gather,developing into the dendrite net and net-shrinkage.With an increase in slow shot speed,the size and number of ESCs and porosities significantly reduce.In addition,the distribution of ESCs is more dispersed and the net-shrinkage disappears.The tensile property is greatly improved by adopting a higher slow shot speed.The ultimate tensile strength is enhanced from 260.31 MPa to 290.31 MPa(increased by 11.52%),and the elongation is enhanced from 3.72%to 6.34%(increased by 70.52%).

Magneto-optical Kerr Effect of Mono-layer NiX_(2)(X=Cl,Br,I):A Density Functional Theory Study

The full-potential linearized augmented plane wave plus local orbital method is utilized for exploring the electronic,magnetic,and magneto-optical properties of the NiX_(2)(X=Cl,Br,and I)single layer.The first-principles calculation demonstrates that these compounds are ferromagnetic indirect semiconductors,and the energy band gaps of NiX_(2)for X=Cl,Br,and I are 3.888,3.134,and 2.157 eV,respectively.The magnetic moments of Ni atoms in NiX_(2)monolayer are 1.656,1.588,1.449μB,and their magneto-crystalline anisotropy energies are 0.167,0.029,0.090 meV,respectively.Based on the macro-linear response theory,we systematically studied the influences of the external magnetic field and out-of-plane strain on the magneto-optical Kerr effect(MOKE)spectrum of the NiX_(2)single layer.It is found that,when the external magnetic field is perpendicular to the sample plane,the value of the Kerr rotation angle reaches the maximum,and the single-layer NiI_(2)material has a Kerr rotation angle of 1.89°at the photon energy of 1.986 eV.Besides,the Kerr rotation spectrum of NiCl_(2)and NiBr_(2)monolayers redshift as the out-of-plane strain increases,while NiI_(2)monolayer blueshifts.Accurate computation of the MOKE spectrum of NiX_(2)materials provides an opportunity for applications of 2D magnetic material ranging from sensing to data storing.

Experimental Analysis of Radial Centrifugal Pump Shutdown

Centrifugal pumps are widely used in the metallurgy,coal,and building sectors.In order to study the hydraulic characteristics of a closed impeller centrifugal pump during its shutdown in the so-called power frequency and frequency conversion modes,experiments were carried to determine the characteristic evolution of parameters such as speed,inlet and outlet pressure,head,flow rate and shaft power.A quasi-steady-state method was also used to further investigate these transient behaviors.The results show that,compared to the power frequency input,the performance parameter curves for the frequency conversion input are less volatile and smoother.The characteristic time is longer and the response to shutdown is slower.The quasi-steady-state theoretical head-flow curves match the experimental head-flow curves more closely at low flow rates when the frequency conversion input is considered.Moreover,in this case,the similarity law predicts the hydraulic performance more accurately.

Adaptive Nonlinear PD Controller of Two-Wheeled Self-Balancing Robot with External Force

This paper proposes an adaptive nonlinear proportional-derivative(ANPD)controller for a two-wheeled self-balancing robot(TWSB)modeled by the Lagrange equation with external forces.The proposed control scheme is designed based on the combination of a nonlinear proportional-derivative(NPD)controller and a genetic algorithm,in which the proportional-derivative(PD)parameters are updated online based on the tracking error and the preset error threshold.In addition,the genetic algorithm is employed to adaptively select initial controller parameters,contributing to system stability and improved control accuracy.The proposed controller is basic in design yet simple to implement.The ANPD controller has the advantage of being computationally lightweight and providing high robustness against external forces.The stability of the closed-loop system is rigorously analyzed and verified using Lyapunov theory,providing theoretical assurance of its robustness.Simulations and experimental results show that the TWSB robot with the proposed ANPD controller achieves quick balance and tracks target values with very small errors,demonstrating the effectiveness and performance of the proposed controller.The proposed ANPD controller demonstrates significant improvements in balancing and tracking performance for two-wheeled self-balancing robots,which has great applicability in the field of robot control systems.This represents a promising solution for applications requiring precise and stable motion control under varying external conditions.

An externally perceivable smart leaky-wave antenna based on spoof surface plasmon polaritons

Smart antennas have received great attention for their potentials to enable communication and perception functions at the same time.However,realizing the function synthesis remains an open challenge,and most existing system solutions are limited to narrow operating bands and high complexity and cost.Here,we propose an externally perceivable leakywave antenna(LWA)based on spoof surface plasmon polaritons(SSPPs),which can realize adaptive real-time switching between the“radiating”and“non-radiating”states and beam tracking at different frequencies.With the assistance of computer vision,the smart SSPP-LWA is able to detect the external target user or jammer,and intelligently track the target by self-adjusting the operating frequency.The proposed scheme helps to reduce the power consumption through dynamically controlling the radiating state of the antenna,and improve spectrum utilization and avoid spectrum conflicts through intelligently deciding the radiating frequency.On the other hand,it is also helpful for the physical layer communication security through switching the antenna working state according to the presence of the target and target beam tracking in real time.In addition,the proposed smart antenna can be generalized to other metamaterial systems and could be a candidate for synaesthesia integration in future smart antenna systems.

Smoothed-Particle Hydrodynamics Simulation of Ship Motion and Tank Sloshing under the Effect of Regular Waves

Predicting the response of liquefied natural gas(LNG)contained in vessels subjected to external waves is extremely important to ensure the safety of the transportation process.In this study,the coupled behavior due to ship motion and liquid tank sloshing has been simulated by the Smoothed-Particle Hydrodynamics(SPH)method.Firstly,the sloshing flow in a rectangular tank was simulated and the related loads were analyzed to verify and validate the accuracy of the present SPH solver.Then,a three-dimensional simplified LNG carrier model,including two prismatic liquid tanks and a wave tank,was introduced.Different conditions were examined corresponding to different wave lengths,wave heights,wave heading angles,and tank loading rates.Finally,the effects of liquid tank loading rate on LNG ship motions and sloshing loading were analyzed,thereby showing that the SPH method can effectively provide useful indications for the design of liquid cargo ships.

Influence of upstream solar wind on magnetic field distribution in the Martian nightside ionosphere

Using over eight years of Mars Atmosphere and Volatile Evolutio N(MAVEN)data,from November 2014 to May 2023,we have investigated the Martian nightside ionospheric magnetic field distribution under the influence of upstream solar wind drivers,including the interplanetary magnetic field intensity(∣BIMF∣),solar wind dynamic pressure(PS W),solar extreme ultraviolet flux(EUV),and Martian seasons(L s).Our analysis reveals pronounced correlations between magnetic field residuals and both∣BIMF∣and PS W.Correlations observed with EUV flux and Ls were weaker—notably,magnetic field residuals increased during periods of high EUV flux and at Mars perihelion.We find that the IMF penetrates to an altitude of 200 km under a wide range of upstream conditions,penetrating notably deeper under high∣BIMF∣andPSWconditions.Our analysis also indicates that EUV flux and IMF cone angle have minimal impact on IMF penetration depth.Those findings provide useful constraints on the dynamic nature of Martian atmospheric escape processes and their evolution,suggesting that historical solar wind conditions may have facilitated deeper IMF penetration and higher rates of ionospheric escape than are observed now.Moreover,by establishing criteria for magnetic‘quiet’conditions,this study offers new insights into the planet’s magnetic environment under varying solar wind influences,knowledge that should help refine models of the Martian crustal magnetic field.

Linking 24-h Movement Behavior Guidelines to Cognitive Difficulties,Internalizing and Externalizing Problems in Preterm Youth

Background:Given the heightened risk of developmental challenges associated with preterm birth,it is crucial to explore interventions that may ameliorate potential adverse outcomes.This study aimed to examine whether meeting the 24-h movement behavior(24-HMB)guidelines,which include recommendations on physical activity(PA),screen time(ST),and sleep(SL),is related to indicators of cognitive difficulties,internalizing problems(e.g.,depression and anxiety),and externalizing problems(e.g.,difficulties in making friends and arguing)in a sample of preterm youth(children and adolescents born preterm).Methods:In this cross-sectional study,data from 3410 preterm youth(aged 6 to 17 years)were included for data analyses.Multivariable logistic regression was used to investigate associations between meeting the 24-HMB guidelines and the above-mentioned health outcomes,while controlling for sociodemographic and health-related factors.Results:The prevalence of meeting 24-HMB guidelines varied across independent and integrated components of the 24-HMB guidelines.Meeting the ST guideline alone(p<0.05)and integrated guidelines(i.e.,ST+SL and ST+SL+PA)were associated with fewer cognitive difficulties and reduced internalizing and externalizing problems(p<0.05).Specifically,meeting the SL guideline alone and integrated guidelines(i.e.,SL+ST)were associated with lower odds of depression and anxiety(p<0.01).Additionally,meeting independent,and integrated(PA and/or ST)guidelines were associated with less pronounced difficulties in making friends and arguing(p<0.05).Meeting 24-HMB guidelines in an isolated and integrated manner are linked to better cognitive performance and fewer internalizing and externalizing problems in preterm youth.Conclusion:Results suggest that advocating for the implementation of the 24-HMB guidelines may reduce cognitive challenges and behavioral issues,which is of high relevance for improving public health.Future longitudinal studies in preterm youth should investigate how modifying specific 24-HMB behaviors,especially ST,influence cognitive difficulties,internalizing and externalizing problems in this vulnerable population.

Current status and prospects of research on safety situation awareness of high speed railway operation environment

Purpose–The safety of high-speed rail operation environments is an important guarantee for the safe operation of high-speed rail.The operating environment of the high-speed rail is complex,and the main factors affecting the safety of high-speed rail operating environment include meteorological disasters,perimeter intrusion and external environmental hazards.The purpose of the paper is to elaborate on the current research status and team research progress on the perception of safety situation in high-speed rail operation environment and to propose directions for further research in the future.Design/methodology/approach–In terms of the mechanism and spatio-temporal evolution law of the main influencing factors on the safety of high-speed rail operation environments,the research status is elaborated,and the latest research progress and achievements of the team are introduced.This paper elaborates on the research status and introduces the latest research progress and achievements of the team in terms of meteorological,perimeter and external environmental situation perception methods for high-speed rail operation.Findings–Based on the technical route of“situational awareness evaluation warning active control,”a technical system for monitoring the safety of high-speed train operation environments has been formed.Relevant theoretical and technical research and application have been carried out around the impact of meteorological disasters,perimeter intrusion and the external environment on high-speed rail safety.These works strongly support the improvement of China’s railway environmental safety guarantee technology.Originality/value–With the operation of CR450 high-speed trains with a speed of 400 kmper hour and the application of high-speed train autonomous driving technology in the future,new and higher requirements have been put forward for the safety of high-speed rail operation environments.The following five aspects of work are urgently needed:(1)Research the single factor disaster mechanism of wind,rain,snow,lightning,etc.for high-speed railways with a speed of 400 kms per hour,and based on this,study the evolution characteristics of multiple safety factors and the correlation between the high-speed driving safety environment,revealing the coupling disastermechanism ofmultiple influencing factors;(2)Research covers multi-source data fusion methods and associated features such as disaster monitoring data,meteorological information,route characteristics and terrain and landforms,studying the spatio-temporal evolution laws of meteorological disasters,perimeter intrusions and external environmental hazards;(3)In terms of meteorological disaster situation awareness,research high-precision prediction methods for meteorological information time series along high-speed rail lines and study the realization of small-scale real-time dynamic and accurate prediction of meteorological disasters along high-speed rail lines;(4)In terms of perimeter intrusion,research amulti-modal fusion perception method for typical scenarios of high-speed rail operation in all time,all weather and all coverage and combine artificial intelligence technology to achieve comprehensive and accurate perception of perimeter security risks along the high-speed rail line and(5)In terms of external environment,based on the existing general network framework for change detection,we will carry out research on change detection and algorithms in the surrounding environment of highspeed rail.